There are many conditions which may result in a person becoming partially or completely edentulous (periodontal disease, an injury, etc.), which in the past had been remedied by the wearing of a prosthetic device, known as dentures. Dentures were constructed to replace the missing teeth and were supported by surrounding teeth and/or by the underlying tissue. The significant drawbacks to the wearing of such partial or complete dentures, principally its means of support, which often required the use of adhesives, as well as its cleaning requirements, served to bolster the development of dental implants.
Today's dental implants are typically root form endosseous (in the bone), being a “root” device (a screw) that is usually made of titanium, and which is inserted into the jaw through the bone at the alveolar ridges. After a healing period, an abutment is attached thereto and may protrude through the periostium and receive a prosthodontic appliance—a new tooth.
It is not uncommon for an implant procedure to be performed on both the maxilla (upper jaw) and the mandible (lower jaw), and in some cases, enough titanium screws may be implanted to replace all of the missing teeth of a completely edentulous person. Although there need not be a corresponding implant screw for each prosthodontic tooth installed, and for the maxilla, where bone density is poorer than the lower jaw, the number of implants will depend on the quality and volume of bone at each prospective implant site. An oral surgeon will generally place 8-10 implants to support a complete set of 14 replacement teeth for the upper jaw. This is done when the final prosthetic device is fixed and only retrievable by the restorative dentist. The same applies to the lower jaw, but a full fixed case can be done with fewer implants, as the lower jaw is generally more favorable for implants in terms of its bone density. Generally, when fabricating a removable prosthesis that is implant supported, 6 implants are used in the upper jaw, and 2 or 4 implants are used in the lower anterior jaw. Each site will require individual preparation and an implant screw, referred to as a “platform,” where the platform's diameter and length is optimum for the geometry of that particular site.
As a general rule, greater strength and better result are obtained for the subsequently installed prosthodontic teeth, by implanting the longest platform with the largest diameter that the bone is able to support locally. Because the physiology of the jaw bones normally varies at different locations throughout the mouth, a range of different size implants may be used at each location. In the front of the mouth, shorter and narrower implants are generally used, and often have diameters in the range of 3.5 mm to 4.2 mm. If a particular patient has an unusually narrow space between two teeth, a “mini dental implant,” being in the range of 2 mm to 3.5 mm, may be used. Towards the back of the mouth, the bone that supports the molars may require implants diameters in the range of 4.5 mm to 6.0 mm, as that is where the strength of the tooth is crucial for mastication. For a full technical discussion of the rationale for particular implant platform sizing, see Contemporary Implant Dentistry, by Carl E. Misch, 3rd Ed., p. 160-177, the disclosures of which are incorporated herein by reference.
The surgeon may make a final selection for each implant platform during the procedure, depending upon final measurements taken of the bone after formation of the implant hole (osteotomy). Variations from a “recommended” platform size are frequently necessary, especially if a “spinner” occurs, which is an implant that does not have good primary fixation. In that case, a wider implant fixture must be placed to achieve proper primary stability. Therefore, the number of different sized/shaped platforms that the oral surgeon may need to have readily available during a procedure, to accommodate all of the implant sites, may often become considerable and unwieldy.
The concerns regarding the health and safety of the dental implant patient are as significant as with any other surgery being performed today. The dental implant surgeon is concerned with many things, including infection at the site of the implant, the potential injury/damage to surrounding blood vessels or teeth, the possibility of nerve damage, the potential for sinus problems when the platform protrudes into one of the sinus cavities, as well as the potential for loss of an implant or fracturing of a patients jaw. The diligent oral surgeon performing implant procedures is thus confronted by an array of issues that must be successfully negotiated in order to meet the accepted standard of practice, many of which principally relate to forming an optimally sized implant hole (osteotomy) for installation of the optimally sized platform (optimal length and width of the implant).
Where the patient requires multiple platforms to be implanted, and with the probability of needing to vary the platform selected for implantation from the “recommended” platform size, the potential for an error resulting in malpractice escalates. Furthermore, increased handling of the vials that contain the platform in a sterile environment also introduces the likelihood of its mishandling, which may result in dropping of the vial and ruining of the sterile seal, which would necessitate the use of a new implant, at additional cost.
The current invention seeks to organize the array of implants that may be used during surgery. The current invention allows an oral surgeon to be well prepared prior to surgery and during the surgery for any deviation from a planned implant size.